Drug Related-Problems in Emergency Departments and The Role of Clinical Pharmacists: A Multi-Center Study in Iraq

Abstract

Drug Related-Problems (DRPs) are common in emergency departments (EDs), where the fast-paced environment increases the risk of medication errors and adverse drug events. limited data are available from Iraq. Accordingly, the current study aimed to assess the prevalence, causes and severity of DRPs in Iraqi EDs and to evaluate the impact of clinical pharmacist interventions (PIs). A cross-sectional, multi-center study was conducted in March 2024 at four major hospitals in Al-Najaf, Iraq. Adult patients (n=500) presenting to ED for non-surgical conditions were included. DRPs were identified and classified using PNCE version 9.0 system. PIs and their acceptance were documented. Data were analyzed using SPSS version 28. DRPs were identified among 80.2% of patients. Drug-drug interactions (39.4%), ineffective medications (39.8%) and cost effectiveness problems (36.2%) were the most common causes. Regarding severity, 55.9% of the total DRPs were mils, 25.1% moderate and 19.1% were sever. A total of 685 PIs were recorded, most commonly were changing in drug instructions (30.4%). Overall, 59.4% of interventions were fully accepted by the physicians resulting in solving of 36.4% of the total DRPs. As a conclusion, DRPs are highly prevalent in Iraqi EDs, with nearly one in five classified as sever. Clinical PIs were effective and frequently accepted. Underscoring the importance of integrating pharmacists into ED team to improve patients' safety.